STEP 1
Download and Fill Out Form
STEP 2
Submit To Insurance
STEP 3
Get Your Money Back
Additional Information
Download and Fill Out the Claim Form
Above, you will find links to claim forms for Medicare and other major insurance providers. To submit a claim, print the appropriate form, fill it out, and send it together with your RespShop invoice to the address listed on the back of your health insurance card. If your insurance company is not listed, you can request the form from them, or you can use the Universal Claim form, which is provided under the "Other Insurance Providers" link.
If the form asks for a diagnosis code, enter the ICD-10 code from your invoice.
If the form asks for a procedure code, enter the HCPCS code from your invoice.
The form may request an NPI number. NPI stands for National Provider Identifier.
RespShop’s NPI number: 1831715739
Submit the Claim Form, Invoice, and Prescription to Your Provider
Mail the form, invoice and your prescription to the address on the back of your insurance card.
Please note that receipts for masks with headgear and machines with humidifiers do not itemize the cost separately as they are packaged items. In case your insurance provider has any queries, feel free to contact us for assistance.
Get Reimbursed
After completing the reimbursement process, send the necessary documents, such as the completed claim form and your RespShop invoice, along with any other documents requested by your insurance provider, to the address listed on the back of your health insurance card. It is recommended that you submit your claim for reimbursement as soon as possible, as insurance companies typically limit reimbursement to events that occurred within one year.
Questions or Concerns
If you have any questions or concerns regarding your insurance provider, please don't hesitate to reach out to us for assistance.
CPAP machines, masks, humidifiers, oxygen concentrators, including stationary and portable, and all related parts are classified as Durable Medical Equipment (DME) by insurance companies. Medicare and most health insurance companies may reimburse you for CPAP equipment, supplies, and other durable medical equipment purchased from RespShop.
We strongly recommend that you contact your insurance company before making a purchase. Insurance policies vary considerably, and it's best to understand your financial obligations upfront. Contacting your insurance company before buying also enables you to determine if there are specific documentation requirements that must be met when submitting your claim for reimbursement. For instance, some companies may require both your invoice and a copy of your prescription.
Your policy may only cover a certain percentage of the cost or require a co-pay amount. For example, Medicare typically covers 80% of CPAP equipment, and you are responsible for the remaining 20%.
Out of pocket purchasing often makes the most sense. Some policies have high deductibles that must be met before any eligibility for reimbursement. In those cases, you can make an informed decision about whether paying out of pocket or filing an insurance claim is the smartest financial decision for you. People with a high deductible or a high co-pay obligation often find that paying out of pocket for CPAP equipment is the most cost-effective and friction-free approach.
Questions to ask your insurance provider before buying
It is advised that you contact your Insurance provider prior to billing your claim. Most insurance companies will cover the cost of your CPAP/BiPAP machine and supplies with appropriate documentation. Some Insurances will not accept paper claims and therefore will only accept an electronic claim. Be sure to confirm with your insurance company these questions.
1May I purchase the CPAP machine and still have it covered?
2Is RespShop in the network or will I be paying out of pocket for this claim?
3Is pre-authorization required?
4Do you accept a paper claim?
5What documentation will I need to send with my claim?
6Will I need to add any modifiers to my claim?
7What percent of the cost of the CPAP equipment is reimbursable?
8What deductible or co-pay amount must be met before I am eligible for any reimbursement?
Are CPAP Machines
Covered by Insurance?
Covered by Insurance?
Glossary of Insurance Terms:
Co-pay:
The amount an insured person must contribute out of pocket toward the cost of care or a medical supply.
CPT:
Current Procedural Terminology. A type of procedure code for medical billing.
Deductible:
The amount of money that a person must spend out of pocket before their insurance starts
to cover expenses.
DME:
Durable Medical Equipment. Insurance-speak for medical supplies that are not meant to be disposed of after one use. CPAP masks, CPAP machines, and CPAP humidifiers are durable medical equipment.
HCPCS:
Healthcare Common Procedure Coding System. This is a procedure code for medical billing.
NPI:
National Provider Identifier. RespShop's NPI number is 1831715739.
Health Savings Accounts (HSA) & Flexible Spending Accounts (FSA)
Do you have a Health Savings Account (HSA) or a Flexible Spending Account (FSA)? CPAP machines, masks, supplies and other related equipment are eligible for HAS & FSA purchasing. For reimbursement through your HAS & FSA, you just need to submit your RespShop invoice.
Some HAS & FSA companies issue credit cards and you can purchase with that card to avoid paperwork. Keep your invoice, however, in case the HAS & FSA audits your purchase.